While Democrats saw modest gains nationally, they dominated midterm elections in New York, taking control of both chambers of the legislature and the governor’s mansion for the first time since 2012, only the second time ever since the mid-1930s. The majority of the incoming legislators have endorsed the New York Health Act (NYHA), a proposal to implement a state-level government-payer system. First introduced in 1992, NYHA has passed the state Assembly five times, but never had the votes needed to pass the Senate.
Like all single-payer plans, NYHA promises to use public funds to provide comprehensive medical coverage to all residents of the state. NYHA is incredibly vague about specific payment arrangements, however, leaving us to guess how those funds will be apportioned to the state’s health-care providers.
A RAND Corporation analysis, released in August, estimated that the bill would not dramatically change New York’s health-care spending in the short run, and might even reduce it by 3 percent by 2031. This is a very generous outlook: it assumes that expanded benefits could be funded by enormous savings from reduced administrative costs and reductions in payments to doctors and hospitals over time.
That’s one scenario. But another is the approach taken by single-payer’s most famous proponent, Vermont Sen. Bernie Sanders. Sanders’ plan would base health spending on current Medicare rates, which are considerably lower than what private insurance pays.
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Tim Rice is deputy director for health policy at the Manhattan Institute. Follow him on Twitter here. Based on a new report (in partnership with the Empire Center), The Impact of Single-Payer on New York Hospitals.
This piece originally appeared in The Federalist